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General NPI Number Information
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NPI Number | 1831916840
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Entity Type | Organization
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Legal Business Name | PAYTON'S PLACE SAFE SPACE
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Dates
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Enumeration Date | 09/21/2024
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Last Update Date | 07/19/2025
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Provider Practice Location Address
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Address Line | 11801 PIERCE ST
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City | RIVERSIDE
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State | CA
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Zip | 92505-4408
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Country | US
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Telephone | 909-435-5136
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Fax |
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Provider Business Mailing Address
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Address Line | 25055 LA MAR RD
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City | LOMA LINDA
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State | CA
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Zip | 92354-2901
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Country | US
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Telephone | 909-435-5136
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FELICIA A PAYTON
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Credential | LMFT
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Telephone | 909-435-5136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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